Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) Project Abstract: Long Term Objectives The Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) provides data for a variety of maternal and child health (MCH) issues. The goal of the study is to reduce the prevalence of maternal and infant morbidity and mortality. PRAMS can accomplish this by providing on-going, state-wide preconception, pregnancy, and postpartum specific data. No other state-wide study focuses on the pregnancy and postpartum experience, making PRAMS a unique and necessary data source for the state. Specific Aims The specific aims of the Oklahoma PRAMS Project are to provide quality, statewide, population- based surveillance data on the Oklahoma State Department of Health?s MCH priorities. Those priorities are: reduce infant mortality; reduce the prevalence of low birthweight and preterm infants; reduce health disparities; reduce unplanned pregnancies; reduce teen pregnancies; improve the mental and behavioral health of women and children; and, reduce chronic health conditions among women of childbearing age. Monitoring behaviors and outcomes across the state on these priorities will enable programs and agencies to provide targeted interventions to populations of need. Research Design and Methods PRAMS contacts new mothers two to six months after delivering a live birth. The sample is drawn from the Oklahoma live birth registry. The PRAMS Project utilizes a mixed mode surveillance system, meaning respondents are sent up to three mail survey packets, followed by telephone contact for nonrespondents. In 2016, respondents will also have a web option, if they wish to participate online. Oklahoma stratifies by maternal race, oversampling African American, American Indian and Hispanic mothers. A response rate of 60% in all strata is required in order to weight the data to the annual birth cohort. Mail packets consist of the PRAMS questionnaire and return envelope, an informed consent sheet, a resource directory, an incentive (Mail 1 only), and a reward sheet (listing several items mothers may choose from for completing the survey). Telephone and web respondents are also offered a choice of rewards. Incentives and rewards are used in an effort to maximize participation in the study. Currently, Oklahoma PRAMS has an overall response rate of 63% and all strata meet the 60% threshold.